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OPEN FRACTURE-An open fracture is a broken bone that penetrates the skin. This is an important distinction because when a broken bone penetrates the skin there is a need for immediate treatment, and an operation is often required to clean the area of the fracture.
CLOSED FRACTURE-A closed fracture is a broken bone that does not penetrate the skin. This is an important distinction because when a broken bone penetrates the skin (an open fracture) there is a need for urgent treatment, and an operation is often required to clean the area of the fracture.

POST OP CARE-
#Rest
#Compression
#Elevation

ORIF-Open reduction internal fixation (ORIF) procedure aims at fixing a bone fracture that is considered to be very serious and in case realignment of the bone to the normal position is required with the help of screws, plates and other equipment. ORIF surgery is a common procedure and is applicable for different bone segments of the body, including the hip, knee, arms, and thighs. ORIF surgery is performed by orthopedic surgeons who have specialization in the musculoskeletal structure of the human body.

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1). Two type of fracture:
Open fracture - where the bone is    protruding out of the skin
Close Fracture - where the bone is broken inside the skin
Post-op care:
Elevate the leg using pillow to reducing swelling
Apply ice to reduce swelling
Take painkillers as prescribed

2). Autograft is a graft retrieved from patient's own body parts.
Allograft is a graft obtained from others.

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1.  3 kinds of care:
- Rest, Ice, Compression, and Elevation (RICE)
- Monitor the vital signs of the patient.
- Wound care/Timely dressing changes/Wound review to prevent infection

2. Types of ORIF
-Screws (Most commonly used and is usually used with other types of implants) (May be removed after recovery)
- Plates (Internal splints to hold bones in place)
- Rods/Nails (For long bone fractures to hold them in place)
- Pins/Wires (Pin back bones which have broken into many smaller pieces)
-External fixators (Temporary frame to hold bones together when skin and muscle have been injured)

3. Difference between autograft vs allograft.
Autograft - Patient's own tissue which is used for surgical reconstruction procedure.
Allograft - Tissue taken from another person used for surgical reconstruction procedure.

Difference - Patients who undergo a procedure with allograft tissue would take longer to incorporate the tissue into the recipient's body.

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Post op care
Rest in bed
Elevate legs on pillow
Apply cold compress

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ORIF:

Open reduction internal fixation is done to repair broken bones

Open fracture:

-Broken bone which has an exit hole in the skin

-concern of infection

Closed Fracture:

-Bone broken under the skin

-concern of soft tissue injury

Preference to autograft vs allograft.

Autograft:

-bone graft taken from patient self

Allograft:

-Bone graft taken from donor

Immediate post op care:

-icing

-elevate leg

-keep incision site clean

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1. Post-op care:

Monitor patient vital signs

RICE: Rest, Ice, Compression & Elevation

Wound Care to prevent infection

2. Different types of ORIF:
- Open and Close fracture

Open reduction means a surgeon makes an incision to re-align the bone.

Internal fixation means the bones are held together with hardware like metal pins, plates, rods, or screw

Transverse

Hair line/green stick

Comminuted

Segmental

Oblique

Spiral

Compression

3. Difference between autograft vs allograft:

Autograft: A patient's own tissue is frequently employed in surgical reconstructive procedures.

Allograft tissue: It takes longer to integrate into the recipient's body when taken from another individual.

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ORIF:
Open reduction and internal fixation (ORIF) is a type of surgery used to stabilize and heal a broken bone. You might need this procedure to treat your broken ankle.

During an open reduction, orthopedic surgeons reposition your bone pieces during surgery, so they are back in their proper alignment.
In a closed reduction, a healthcare provider physically moves the bones back into place without surgically exposing the bone.

Internal fixation refers to the method of physically reconnecting the bones. This might involve special screws, plates, rods, wires, or nails that the surgeon places inside the bones to fix them in the correct place. This prevents the bones from healing abnormally. The entire operation usually takes place while you are asleep under general anesthesia.

Concerns:
-Blood clots
-Bleeding
-Infection

Difference between autograft vs allograft:
Autograft, patient own tissue that can often be used for a surgical reconstruction procedure.
Allograft tissue, taken from another person, takes longer to incorporate into the recipient's body.

Care of patient immediate post-op:
-Apply ice therapy to prevent swelling & reduce pain.
-Encourage patient to eat painkiller to minimize pain.
-Educate patient to not put pressure on on operated leg.

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1.care of patient immediate post -op
-Maintain a clean and dry dressing. Check for bleeding
- Ice to minimise swelling and discomfort
- pain killer to minimise pain

2. type of ORIF for the various ortho fractures
- plate ,screw, pin ,rod, nail, wire

3.difference between autograft and alllograft
Autograft is bone graft taken from patient him/herself.

Allograft is bone graft taken from donor

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REST
ICE
Elevate

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1. Apply Ice pack to patient to reduce swelling
2. Elevate patient’s feet by using pillow
3. Monitor patient’s pain score and vital signs

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1. Learned about the different types of ORIF
2. Learn about post op care

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1) Open Fracture (Bone exposure on the skin, risk of infection is higher)
2) Close Fracture (Skin is intact)

Fracture: transverse, hair line/green stick, comminuted, segmental, oblique, spiral, compression.

Autograft: from patient own body (usual iliac crest, from fracture site, ribs can use for spine surgery)

Allograft: 1) From donor cadaver 2)Coral material as substitute

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For open reduction, orthopedic surgeons reposition the pieces of the fractured bone surgically so that bones are back in their proper alignment. In a closed reduction, surgeon physically moves the bones back into place without surgically exposing the bone.
The use of auto-graft or allograft is evaluated by the surgeon and patient together depending on the patient's medical condition and preference. Allograft usually expensive and might cause infection or rejection for long term use.

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1.  Types of ORIF for various fractures

Open Reduction Internal Fixation (ORIF) – Surgery to fix severely broken bone that cannot fix by cast or splint. Open Reduction means an incision made to realign the bone. Internal fixation means using hardware like metal pins, plates, rods or screws to held bone together.

2.       Difference between autograft vs allograft

Autograft is bone graft taken from patient him/herself.

Allograft is bone graft taken from donor (another person)

3.       Concerns on open vs close fracture

Open fracture – a fracture where there is an open wound or break in skin near site of broken bone.

Concerns – Bacteria from dirt & other contaminants can enter the wound cause infection.

Close fracture – Broken bone does not penetrate the skin.

Concerns – Soft tissue injury, damage of blood vessel, infection

3 immediate post op care that will prevent complication

1. Apply ice to reduce swelling

2. Maintain incision clean prevent infection

3. Elevate leg to reduce swelling

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Post-op care after ORIF:
* Keep the dressing clean and dry. Monitor for bleeding.
- Ice to prevent swelling & reduce pain
- Pain killer for pain control

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1)      Types of ORIF for the various fractures

open reduction internal fixation (ORIF) refers to a surgical procedure to fix severely broken bones. Open reduction means surgery is necessary to reorient the bone fracture into the normal position. Internal fixation refers to the hardware such as metal pins, steel rods, screws, or plates used to keep the bone fracture stable in order to heal the right way and to help prevent infection.

The most common fixation is open (ORIF) and closed (External fixation).

The type of Fractures has: Transverse fractures, spiral fractures, Compression fractures, Displaced fractures, Greenstick fracture, Comminuted fractures, Epiohyseal fractures, Pott’s fracture, Colles fracture.

2)      Difference between autograft vs allograft

Autograft is the graft obtained from patient’s own body.

Allograft is the graft obtained from other sources: such as from other human body(same species),but is from one individual to another individual of the same species who is not an identical twin.

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ORIF: Implants are compatible with the body and rarely cause an allergic reaction.

Plates. Plates are like internal splints that hold the broken pieces of bone together. ...

Screws. Screws are used for internal fixation more often than any other type of implant.

Nails or Rods.

Autograft : use patient’s own bone or tissue
Allograft: use other people’s bone or tissue

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Peter - Week 5 - E-Learning - Orthopedic Surgery

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Peter - Week 5 - E-Learning - Orthopedic Surgery

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1. What you have learned from the types of ORIF for the various fracture?

Generally, Open reduction internal fixation (ORIF) is a surgery to fix severely broken bones. It’s only used for serious fractures that can’t be treated with a cast or splint. These injuries are usually fractures that are displaced, unstable, or involve the joint. “Open reduction” means a surgeon makes an incision to re-align the bone.  “Internal fixation” means the bones are held together with implants like metal pins, plates, rods, or screws.

4 AO Principal of fracture fixation;

1. Fracture Reduction- Realign / Reposition

2. Fracture Fixation - (Absolute/Relative Stability).

3. Preservation of Blood Supply - Soft tissue and bone

4. Early Mobilization

Types of displacement/fracture:

1. Translation, 2. Angulation, 3. Shortening. 4. Rotation

Types of Reduction:

Anatomical - All pieces are put together perfectly

Functional - Focus on restoring length, alignment, and Rotation

Indirect Bone Healing - Casting/Splint/Ext. Fix/ IM Nailing/ Traction
Direct Bone Healing - Plates & Screws

1. Types of ORIF are roughly divided into a few major categories of implants: Wires, Pins and Screws, Plates, and Intramedullary nailing or Rods.

Picture shows the anatomical location for LCP Plate implant for the patient's bone.

1. Concerns about open fractures vs closed fractures?

Open fracture (compound fracture): The bone pokes through the skin and can be seen. Or a deep wound exposes the bone through the skin.

Concern - once the skin is broken, bacteria from dirt and other contaminants can enter the wound and cause infection.

Closed fracture (simple fracture). The bone is broken, but the skin is intact.

Concern - Blood vessel damage, compartment syndrome, infection, joint problems.

1. Difference between autograft vs allograft.

A patient's own tissue - an autograft - can often be used for a surgical reconstruction procedure. Allograft tissue, taken from another person, takes longer to incorporate into the recipient's body.

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1) Elevate the leg with pillow to reduce swelling
2) Monitor vital sign every 5 mins for 20-30mins times before sending patient back to ward. Ensure vital sign is stable
3) Monitor dressing ensure is dry and intact (NO BLEEDING)
4) Perform circulation check hourly (colour, capillary refill <3sec, pulse check, temperature, sensation). This check can ensure blood circulation of the limb is good and monitor the sign or compartment syndrome.

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3 immediate post op care that will do to prevent complications：

1.    Keep dressing intact, dry and clean. observe bleeding, prevent post op infection and bleeding

2.    Monitor patient’s vital signs, Hourly parameter and monitor patient’s pain score, can apply icebag on operated ankle to reduce the swelling and pain

3.    Elevate the operated leg.

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3 immediate post op care:
- Putting on Cast on patient to prevent excessive movement that make dislocate the implants
- Ice therapy to prevent swelling & reduce pain
- Educate patient not to put pressure on operated leg.

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3 Immediate Post-Op Care for Ankle Fracture:
1. Monitor Patient Vital Signs as the patient just come off the anesthesia. Monitor patient Pain Score.

2. Icing is an important part of recovery from surgery. Reduce swelling and inflammation by applying ice for 20 minutes every hour. Usually, a splint will be placed after the surgery for an ankle fracture. The ice can be placed over the splint and be sure not to let the splint get wet., Care of the splint is important.

3. Keeping the patient leg elevated above the heart level to decrease swelling. This is one of the most important parts of recovery and pain control. Remember, 'Toes above your nose".